Henning-Smith C. The unique impact of COVID-19 on older adults in rural areas. ": to engage older patients online, listen to them about their lives offline. The need factors are defined as those that are imperative and require action to be taken and such relevant variables for the study are: disease, symptoms, health status, and disability days. The eigenvalues associated with the correlation matrix were also obtained. In the case of religion, one could expect that extreme views which disagree with use of health care services would be completely ameliorated by majority of positive thinking towards scientific medical care. According to the main healthcare services, most of the articles (9 articles; 18%) were related to mental health services, followed by Telehealth and digital health services (Fig. Recommendations under the auspices of the polish psychiatric association. The inability to access the full-text document of all the abstracts potentially fulfilling the inclusion criteria should be considered as one of the limitations of the present study. Box , Harar, Ethiopia From each stratum, clusters were drawn on the basis of whether health institutions are hospitals or clinic/centers. Bethesda, MD 20894, Web Policies Saeed et al. Using an iterative team approach to selecting studies and extracting data. Table 4 shows that need factors ranked first, followed by enabling factors, predisposing factors and lastly by health services factors. Stages of villness and Medical Care. Correspondence to Millenson ML. This meant that cases (respondents) have to be drawn at these various levels. PubMed Central 2004; Wong et al. The other outputs of the factor analysis included the communalities and the percentage of variance explained. In addition, among the older people during the COVID-19 pandemic, the need to improving positive coping strategies [33] and more substantial psychosocial support [11] are considered as mental health strategies. This approach included six main steps for conducting the scoping reviews as follows: Clarifying and linking the purpose and research question, This scoping review was designed to answer the question that "what are the main factors affecting the access and utilization of health services among the elderly population during COVID -19 pandemic? This benefit of doubt was supported by the chi-square tests which showed, that, with the exception of the fourth variable (type of facility), the values were statistically significant (<0.05). Cardoso FS, Borges A, Botelho I, Real A, Arajo AC, Domingos G, et al. Calculated chi-squares at corresponding degrees of freedom provided further tests of significance for values obtained. Furthermore, according to Qureshi (2002), demographic factors and social and economic determinants can affect the political directions and the provision of health services for the elderly and the number of allocated resources to the older populations health needs [62]. At best therefore, the influence of religion remains unclear. Currently, knowledge about the health status and utilization of health-related services among newly arrived Asians is limited. However, the presence of health facilities alone is not enough to guarantee use as other socioeconomic factors could influence access and utilization. https://doi.org/10.1111/imj.15328. This gave a total of 20 supposedly influential variables which can still be regarded as unmanageable. between health care utilization and education but it had a positive relationship with private health care utilization. ", Balancing feasibility with breadth and comprehensiveness of the scoping process. Such a condition causes the necessity of more compliance to recommendations [36] along with a comprehensive understanding of ageism [48]. However, this kind of accommodation can barely affect and worsen the condition of morbidity of the diseases, particularly during the COVID-19 pandemic. A sample size of 1200 was adopted in consideration of three factors namely: the need to minimize the sampling error by making the sample as large as possible; factor analysis procedure which relates independent variables to number of cases to increase reliability and validity; and the enormous amount of resources required for a large sample. Omorogiuwa TB. COVID-19 pandemic and mental health care of older adults in India. In Singapore, until recently, publically funded/subsidized oral health care for adults has been limited to basic primary care at government-funded polyclinics. Schrack JA, Wanigatunga AA, Juraschek SP. A UK survey of COVID-19 related social support closures and their effects on older people, people with dementia, and carers. While identifying/confidential patient data should not be published within the manuscript, the datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. However, some studies have been carried out on utilization of specific services. Factor-analyzed data was intended to produce a correlation matrix. Although this may appear a short gun analytical approach, it was nonetheless effective in determining the relative importance of each of the model components. 1. Article official website and that any information you provide is encrypted Int J Environ Res Public Health. "Will you hear my voice? https://doi.org/10.1186/1748-5908-5-69. Wong SYS, Zhang D, Sit RWS, Yip BHK, Chung RY, Wong CKM, et al. The NFHS-4 is a nationally representative sample survey of 601,509 households, 699,686 women aged 15-49 years with a response rate of 97%, and 112,122 men aged 15-54 years with a response rate of 92%. BP has designed the study, finalized the search strategy and implemented the thematic analysis, MM and MB have searched and screened the articles and extracted the initial codes for data charting. There was a decay effect of the distance on the health care service utilization, i.e., as the distance increases from the healthcare facilities; utilization of services was reduced [30-32]. The sampling procedure had those features that tend to polarize service utilization along rural/urban, public/private and hospital/clinic dimensions implicitly built into it for the right analysis. Moore RC, Hancock JT. https://doi.org/10.2217/nmt-2020-0041. 2017;10(1):244266. This study assessed the community perceptions and factors affecting the utilization of health services in a rural community in Southern Nigeria. London: Institute of Health Equity; 2020. Department of Business Administration, University of Ilorin, Ilorin, Nigeria, Corresponding author: Jimoh Ayanda Oladipo Department of Business Administration University of Ilorin, Ilorin, Nigeria. Article Andersen RM, Davidson OL. Prev Chronic Dis. A few other studies have focused on use of health care services by identified groups such as students25, the elderly and rural dwellers26, while the effect of certain policies such as the national health insurance scheme on utilization has also been studied27. Schfer I, Hansen H, Menzel A, Eisele M, Tajdar D, Lhmann D, et al. It should be noticed that false information can be disseminated very fast and with the higher speed and impact of accurate health information and education. JAMA Intern Med. The subthemes accommodated three concepts: acute COVID-19 services, the need for supplementary oxygen and ICU services. Studies have pointed to developing telehealth for old patients [11, 29, 33, 35, 39] while the others have mentioned new ways to use telehealth services similar to video visits [18], digital image prescriptions [20], E-Prescribing, online health services [22], tele palliative care [23] and teledentistry [24]. Palliative Care for Older Adults with multimorbidity in the time of COVID 19. Also, interpretation of religious services would vary from religion to religion and from person to person. Globally more than 70 percent of maternal deaths are due to five major complications (which are direct obstetric complications): hemorrhage (25 percent), infection (15 percent), complication of unsafe abortion (13 percent), hypertension (12 percent), and obstructed labor (8 percent). The present PCC was defined as follows: Population: elderly population, Context: access and utilization during COVID-19 pandemic and Concept: health service access and utilization. The majority of published literature came from the United States (n=18; 36%), followed by India (n=4; 8%). If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Article Health Manpower Requirements for the Achievement of HFA/2000 through PHC: Report of a WHO Expert Committee. Use of health services. The .gov means its official. The decision to include both symptom and disease is informed by differences in decision criteria about seeking care that can possibly follow a mere symptomatic feeling of ill-health and actually being diagnosed with an ailment. Smoli , ipin I, Meimurec P. Access to healthcare for people aged 50+in Europe during the COVID-19 outbreak. https://doi.org/10.31128/AJGP-04-20-5390. In developing countries, attempts have been directed towards promoting utilization particularly among the rural populations but success has been limited. 2021;69(9):240411. Int J Environ Res Public Health. Careers, Unable to load your collection due to an error. The effect of COVID-19 pandemic and lockdown on consultation numbers, consultation reasons and performed services in primary care: results of a longitudinal observational study. 2020;63(5):64650. Main outcomes measures (1) Factors influencing the decision to visit a governmental or private primary care provider and (2) the association of sociodemographic characteristics and patients' decision to attend a given provider. For instance, 'place of residence [6, 50], their social group [6, 51] and group activities [34], limited social activities [11] and social networks [11] accompanied 'with living arrangements [6] and the inequalities related to rural/urban inhabitants [50] and being homebound [52] are among the essential social determinants in the present literature. Archives of Public Health Studies have identified a higher prevalence of known risk factors for suicide [30, 33], increased risks of mental and physical health problems [32], susceptibility to the effects of stress and major depression [12, 29], probability of mental disorders [12] as well as preexisting or experience of loneliness [19, 30, 33, 35]. Not much work has been done in this area that can assist in the planning and management of HCDS in Nigeria. Glob Health. https://doi.org/10.1093/gerona/glaa163. Foster MV, Sethares KA. The underlying assumption for the second objective of this study was that utilization patterns could be expected to differ between the urban areas (Location 1) and the rural areas (Location 2) based on differences in the socio-economic and cultural characteristics of the two groups. For example, a model9 identified six aspects of symptoms which were combined with cultural and psychological costs of treating symptoms. Abualfadl E, Ismail F, Shereef RRE, Hassan E, Tharwat S, Mohamed EF, et al. 2). Odone A, Lugo A, Amerio A, Borroni E, Bosetti C, Carreras G, et al. These changes are obvious in the areas of consulting, oral health, palliative care and so on. Seven main themes emerged from the thematic analysis, as determinants of elderly's access and utilization of healthcare services during COVID-19 pandemic. This chapter will address those factors. Consequently, only sex for urban areas and ethnicity for rural areas could be regarded as important in determining utilization in the respective locations. Each or any set of the variables could be, as indeed has been, used to construct models to determine empirically the extent to which any of them may be operative in a particular situation. Mahnaz Samadbeik. Free medical services as a means of improving utilization through the elimination of financial barriers has formed a major issue of political activism. Implementing digital literacy programs in elderly populations [32] is emphasized in the included studies. Larger models of health care utilization can in general be delineated along economic, social and psychological lines. The first8 was in fact motivated by the need to review planning efforts and their appropriateness viewed from the context of health services utilization. Int Psychogeriatr. OBJECTIVES: To evaluate the current situation of health services utilization of chronic disease patients, and analyze the factors affecting the medical services utilization according to the framework of Andersen's behavior model, so as to provide a reference basis for rational allocation of resources, improvement of . Access to home care services is among other sub-themes in this area. Front Psychiatr. Federal government websites often end in .gov or .mil. Differences in health status, based on indices such as infant mortality, young and child mortality and maternal mortality, between developed countries and developing countries have witnessed historical documentation1. 5, the mutual relationship between the access of the elderly to COVID-19 related services and non COVID-19 related is centrally mentioned that can be affected by the personal determinants the same as the elderlys accommodation challenges and their perceived attitude of aging. Factors, Influential Variables and their Factor Loading and Communalities - Total Sample, Source: Derived from analysis of field survey data, 2011. In the United Kingdom, the comprehensive National Health Scheme (NHS) is structured to ensure equity and encourage all constituents to seek the use of services. The cases were then drawn from these. Another important factor in the utilization of maternity care services, especially in Africa, Siette J, Seaman K, Dodds L, Ludlow K, Johnco C, Wuthrich V, et al. In this regard, evidence shows that some older peoples demographic characteristics, together with visual and auditory abilities, and their physical and mental capabilities, can highly affect their tendency and ability to accept and use tele health care [59]. Giebel C, Lord K, Cooper C, Shenton J, Cannon J, Pulford D, et al. Adopting consultation as a required component of scoping study methodology. For this . This situation is a call to restructuring which can only be facilitated by x-raying the relationship between distribution of resources, health problems and patterns of utilization whereby identified determinants would reveal the services to be provided for the growing population as well as their magnitude. To this extent, it could be inferred that factors determining utilization were different between the two groups. 2020;38(2):913. The elderly's nutritional challenges [29] and the issues related to their caregivers and nurses are also among the other sub-themes mentioned in this area. Another important sub-theme in this area is the existing policies and structure to preserve the continuity of critical health services during the COVID-19 pandemic. Its features include large representative samples, large number of variables and suitable but sophisticated techniques oriented towards successful research effort. Before A four-stage model of service utilization was constructed with 31 variables under appropriate model components. This is quite different from what obtains in the developed countries where services are readily available and different health insurance plans have substantially reduced the formidability of financial barriers. J Aging Soc Policy. https://doi.org/10.1093/gerona/glaa102. A total of 4308 articles were available after a preliminary search from the four databases; 187 articles were included for full text reading, and a total of n=50 articles were selected for this review after confirming eligibility. Less is known about the demographic and socioeconomic factors that affect prescription drug use. Factors That Affect Health-Care Utilization The committee was tasked with identifying factors that influence a person's use of health-care services, including poverty and level of urbanization. Peters M, Godfrey C, McInerney P, Soares C, Khalil H, Parker D. The Joanna Briggs institute reviewers' manual 2015: methodology for JBI scoping reviews. and transmitted securely. Mills JP, Kaye KS, Mody L. COVID-19 in older adults: clinical, psychosocial, and public health considerations. Soc Media+ Soc. 2021:117. (2020) have mentioned five main challenges that older people experience during COVID-19 pandemic [4]. https://doi.org/10.1007/s10691-020-09437-z. BMC Med Res Methodol. Bell JS, Reynolds L, Freeman C, Jackson JK. Hamiduzzaman et al. A thesis submitted in partial fulfilment of the requirement for the degree on Master of Public Health By Jean Gilleard Lyatuu Tanzania Declaration: They nonetheless also generated one or two contradictions. 2020;5(10):e139292. Mechanic D. Correlates of physicians utilization: policy do major multivariate studies of physician utilization find trivial psychological and organizational effects. Barriers to telehealth access among homebound older adults. At the same time, as Banerjee (2020) stated, the fear and uncertainty resulting from the pandemic can cause older people to suffer more senses of loss, anxiety, fear, loneliness, or sometimes, self-neglect and indifference [58]. This article examines factors that affect the utilization of health care services and home- and community-based care (HCBC) programs by older Taiwanese, a rapidly growing and newly arrived immigrant group. In pandemic scenarios, such as COVID-19, these barriers to access and utilization of services can appear prominent. Barriers to health care access among the elderly and who perceives them. Lancet Psychiatr. https://doi.org/10.1016/j.maturitas.2020.04.004. Underutilization of public sector health facilities in Imo State, Nigeria: a study with focus group. The process of open coding was continued and through a final reviewing and refining initial codes via merging the similar codes and omitting the duplications, the final codes were explored and labelled. 2004;94(10):178894. Despite all studies being conducted in conflict-affected regions, only nine studies explicitly identified conflict as a direct barrier to accessing ANC. 2020;32(45):396402. A literature review on factors effecting the utilization of family planning services Among Women Living With HIV in Tanzania. Limited access to routine health care [10] and reduced accessibility of health care for older patients [24, 30, 35] has potentially contributed to an increase in the number of delayed or missed medical appointments [30] and medical comorbidities [30, 35] among the elderly. Health services factors are those having to do with actions and conducts tending towards the welfare of others. 2021;18(3):1148. The procedure involved stratifying the State into rural and urban areas. House to house survey of access to and use of public health facilities in Metropolitan Lagos, Nigeria. This approach helped us to achieve and explore the content as the main and sub-determinants of access and utilization of health services by the elderly population during COVID-19 pandemic. However, finding from the same analytical procedure on data from the urban areas indicated that a model which does not contain the health services factors could be adequate for explaining utilization. https://doi.org/10.1080/08959420.2020.1770036. Elhadi M, Alsoufi A, Abusalama A, Alkaseek A, Abdeewi S, Yahya M, et al. The objectives determine the relative importance of the various predisposing, enabling, need and health services factors on utilization of health services; similarity between rural and urban areas; and major explanatory variables for utilization. Although a correlation matrix would not provide much explanation of the structure of interdependence between variables, it represents an appropriate method of orthogonal transformation of the raw data since the variables have different measurement attributes. Health policies and the systems structure, along with complex demographic, physical, social, cultural and economic factors, can also play a dominant role in this regard. The rejection of the null hypothesis for the other three indicated that the values could only have resulted by chance (5 out of 100 chances). The measures of association provided additional criterion for comparing the influential variables in the rural and urban areas based on four nominal variables. This is because it had fairly acceptable values of Cramer's v (0.207) Tau c (0.190) and Pearson's r (0.180) as well as a chi-square value (67.1) for 4 degrees of freedom much higher than was necessary to reject the null hypothesis. Success in this direction has been limited due to inappropriate structures that result from not tuning planning and management activities towards utilization, a situation compounded by other existing problems including3,4,5: These problems have resulted in inappropriate structures, faulty allocation of resources and incongruent staff scheduling6 which would not have arisen if potential utilization had formed the bases upon which the establishment of the facilities were initially hinged. Through the study the team have identified key factors contributing to the catastrophic cost of TB care and have developed . To the extent that utilization entails the cooperation and invitation of people outside the health system crystallizes the magnitude of the problem. This underlines current efforts in relating utilization to resources as well as to past and present planning efforts. The PRISMA flowchart of the scoping review, Incorporating a numerical summary and qualitative thematic analysis. In other words, the use of virtual social media and other digital applications by old people can be accompanied by inconvenience, stress, incapability or not being user-friendy. 8600 Rockville Pike Accelerating the Achievement of HFA/2000 in member States of WHO (in the African Region) through action at the Local Level; Ninth Regional Programme Meeting; 1822 Nov. 1985; Brazzaville.
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factors affecting utilization of health care services pdf
